title: Experience with laparoscopic treatment for paraesophageal hiatal hernia.
abstract: BACKGROUND
  Paraesophageal hiatal hernia is often associated with a number of complications such as intestinal obstruction, gastric volvulus and acute pancreatitis, each of which can result in critical conditions requiring surgery. Herein, we report our surgical procedure for paraesophageal hiatal hernia.
  
  
  METHODS
  Since 2003, we have surgically treated hiatal hernia in 18 patients, including 2 men and 16 women, with a mean age of 73 years. Thirteen patients (72.2%) had a type-I hiatal hernia, two (11.1%) had type III and three (16.7%) had type IV. The operative procedure consisted of a crural repair and anti-reflux maneuver.
  
  
  RESULTS
  Laparoscopic procedures were completed in all patients. The mean operation time was 160.2 min for type I and 230.8 min for types III and IV. The mean postoperative hospital stay was 7.8 days, and there was no mortality. Three patients relapsed during the mean follow-up period of 74.9 months. Two of them were asymptomatic and one required laparoscopic reoperation.
  
  
  CONCLUSIONS
  Laparoscopic surgery for paraesophageal hiatal hernia is safe and effective with minimal morbidity and early recovery. However, it is important to determine the appropriate timing of surgery based on the severity of the hernia and the patient's general status and comorbidities.
authors.affiliation: Department of Surgery, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Japan.
authors.forename: Nobumi
authors.initials: N
authors.lastname: Tagaya
authors.forename: Nana
authors.initials: N
authors.lastname: Makino
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Saito
authors.forename: Takashi
authors.initials: T
authors.lastname: Okuyama
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Kouketsu
authors.forename: Yoshitake
authors.initials: Y
authors.lastname: Sugamata
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Oya
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006551:Hernia, Hiatal / Q000175:diagnosis / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011860:Radiography, Abdominal; D012086:Reoperation; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Hernia repair; laparoscopic surgery; paraesophageal hiatal hernia